Abstract
Background: Retinopathy of Prematurity (ROP) is a potentially blinding eye disorder that is seen in premature
infants. Data is scanty on prevalence rates in Africa. This study was done to determine the prevalence and
risk factors for ROP in a rural hospital in Kenya.
Design: A prospective cohort study.
Methods: The study was carried out at the Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu,
Kenya between March 2015 and April 2016 in the neonatal unit and outpatient eye clinic. Infants less than
32 weeks gestation and/or weighing less than 1500 grams at birth, plus those with an unstable clinical
course had a dilated fundoscopic examination starting at 28 days of life. Exam findings were recorded using
standard IC-ROP classification. Examinations were repeated every 1-2 weeks until mature vasculature in
zone III was confirmed. Infants were excluded if they died before the ROP outcome or if they did not show
up for the first outpatient exam.
Results: One hundred and thirty one neonates were included in the study, with a male to female ratio of
1:0.95 (64/67). Mean gestational age was 30.64 ± 3.6 weeks and mean birth weight was 1478 ± 414.08 grams.
Of these, 91 (69.5%) had been on oxygen, with a mean of 4.6 ± 5.9 days on oxygen. Four babies developed
ROP (a prevalence of 3.05%). Three (75%) had zone II, stage 1 ROP and one (25%) had zone II, stage 2 ROP;
all regressed without treatment. No infant developed vision-threatening ROP. Peri-natal risks identified
in this group included respiratory distress syndrome, prolonged oxygen administration, intra-ventricular
haemorrhage and seizures.
Conclusion: ROP prevalence was much lower than that reported in other studies, with all cases of ROP
regressing without treatment. The presence of ROP in this setting however, makes a case for screening in
hospitals in rural areas.
References
Adio AO, Ugwu RO, Nwokocha CG, Eneh AU.
Retinopathy of prematurity in Port Harcourt,
Nigeria. ISRN Ophthalmol. 2014; 2014: 481527.
Statistics, KNBO. Kenya population and housing
census. Kenya National Bureau of Statistics: www.
knbs.or.ke/index.php?...population...population...
census-2009, 2009.
Prematurity, I. C. f. t. C. o. R. o., The international
classification of retinopathy of prematurity revisited.
Arch Ophthalmol. 2005; 123 (7): 991-999.
Gilbert C, Fielder A, Gordillo L, Quinn G, Semiglia
R, Visintin P, Zin A, Group IN-R. Characteristics
of infants with severe retinopathy of prematurity
in countries with low, moderate, and high levels of
development: implications for screening programs.
Pediatrics. 2005; 115 (5): e518-525.
Wheatley CM, Dickinson JL, Mackey DA, Craig
JE, Sale MM. Retinopathy of prematurity: recent
advances in our understanding. Br J Ophthalmol.
; 86 (6): 696-700.
December 2018 Journal of Ophthalmology of Eastern Central and Southern Africa
Njuguna M, Msukwa G, Shilio B, Tumwesigye C,
Courtright P, Lewallen S. Causes of severe visual
impairment and blindness in children in schools
for the blind in eastern Africa: changes in the last
years. Ophthalmic Epidemiol. 2009; 16 (3):
-155.
Ruhagaze P, Njuguna KK, Kandeke L, Courtright P.
Blindness and severe visual impairment in pupils at
schools for the blind in Burundi. Middle East Afr J
Ophthalmol. 2013; 20 (1): 61-65.
Kello AB, Gilbert C. Causes of severe visual
impairment and blindness in children in schools
for the blind in Ethiopia. Br J Ophthalmol. 2003;
(5): 526-530.
Wanjala I, Ilako D, Kariuki L. Retinopathy of
prematurity as seen in two major hospitals in
Nairobi, Kenya. East Afr J Ophthalmol. 2007; 13
(1): 5-14.
Mayet I, Cockinos C. Retinopathy of prematurity in
South Africans at a tertiary hospital: a prospective
study. Eye (Lond). 2006; 20 (1): 29-31.
Quinn GE. Retinopathy of prematurity in
Brazil: an emerging problem. J Pediatr (Rio J).
; 83 (3): 191-193.
Saunders RA, Donahue ML, Christmann LM,
Pakalnis AV, Tung B, Hardy RJ, Phelps D L.
Racial variation in retinopathy of prematurity.
The Cryotherapy for Retinopathy of Prematurity
Cooperative Group. Arch Ophthalmol. 1997; 115
(5): 604-608.
Port AD, Chan RV, Ostmo S, Choi D, Chiang
MF. Risk factors for retinopathy of prematurity:
insights from outlier infants. Graefes Arch Clin
Exp Ophthalmol. 2014;
Good WV, Hardy RJ, Wallace DK, Bremer D,
Rogers DL. et al. β-Blocking and racial variation
in the severity of retinopathy of prematurity. Arch
Ophthalmol. 2012; 130 (1): 117-118.
Quinn GE. What do you do about ROP screening
in “big” babies? Br J Ophthalmol. 2002; 86 (10):
-73.